Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, United Kingdom.
Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, United Kingdom; School of Life and Health Sciences, Aston University, Birmingham, United Kingdom; University College London and Institute of Neurology, London, United Kingdom.
Neurosci Biobehav Rev. 2020 Dec;119:320-332. doi: 10.1016/j.neubiorev.2020.10.008. Epub 2020 Oct 18.
Tourette syndrome (TS) is a neurodevelopmental condition characterized by multiple tics. Sensory symptoms play a key role in the clinical phenomenology and pathophysiology of TS, as most patients report premonitory urges driving tic expression. Interestingly, sensory symptoms have also been reported in other conditions characterized by repeated behaviors. This review explores the nature of sensory symptoms reported by patients with body focused repetitive behaviors (BFRBs, especially trichotillomania and skin picking disorder) and restless legs syndrome (RLS) in comparison to TS. A sense of mounting inner tension and reinforcement mechanisms driven by gratification and relief on expression of the tic or repetitive behavior appear to be implicated across all conditions. Subjective urges can be temporarily suppressed by patients with TS and selected BFRBs, whereas patients with RLS tend to report dysesthesia more frequently than a suppressible urge to move. The observed similarities in the phenomenology of sensory symptoms across these conditions raise the possibility of a comparable underlying pathophysiology. Preliminary findings suggest an overlap of neural pathways encompassing the insula, basal ganglia (putamen), and posterior cingulate cortex.
妥瑞氏症候群（TS）是一种神经发育障碍，其特征为多种抽搐。感觉症状在 TS 的临床现象学和病理生理学中起着关键作用，因为大多数患者报告说，预感促使抽搐表现。有趣的是，在其他以重复行为为特征的情况下也有报告感觉症状。本综述探讨了身体聚焦性重复行为（BFRBs，尤其是拔毛癖和皮肤搔抓障碍）和不宁腿综合征（RLS）患者报告的感觉症状的性质，与 TS 进行比较。在所有情况下，似乎都涉及到内在紧张感的增加和由满足感和表达抽搐或重复行为带来的缓解的强化机制。TS 患者和一些选择的 BFRBs 患者可以暂时抑制主观冲动，而 RLS 患者则往往比抑制移动的冲动更频繁地报告感觉不适。这些情况下感觉症状的表现相似性表明存在类似的潜在病理生理学。初步研究结果表明，包含脑岛、基底节（壳核）和后扣带皮层的神经通路存在重叠。
